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Prognostic role of myocardial tumor necrosis factor-alpha and terminal complement complex expression in patients with

Oliver Zimmermann1, Matthias Kochs, Thomas P Zwaka

  • 1Department of Internal Medicine II-Cardiology, University of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany. oliver.zimmermann@medizin.ni-ulm.de

European Journal of Heart Failure
|May 30, 2006
PubMed

Insights

Tumor necrosis factor-alpha (TNF-alpha) and the terminal complement complex (C5b-9) are common in dilated cardiomyopathy (DCM) hearts but do not predict patient outcomes. Myocardial TNF-alpha is not a reliable prognostic marker in DCM.

Area of Science:

  • Cardiology
  • Immunology
  • Pathology

Background:

  • Elevated plasma tumor necrosis factor-alpha (TNF-alpha) levels in dilated cardiomyopathy (DCM) patients are linked to poor prognosis.
  • The terminal complement complex (C5b-9) can stimulate myocardial TNF-alpha expression.

Purpose of the Study:

  • To determine if myocardial expression of TNF-alpha and C5b-9 correlates with clinical outcomes in DCM patients.
  • To assess the prognostic value of myocardial TNF-alpha in DCM.

Main Methods:

  • Myocardial biopsies from 71 DCM patients were analyzed for TNF-alpha, C5b-9, inflammation markers, and viral genomes.
  • Patients were categorized into three groups based on TNF-alpha and C5b-9 expression levels.
  • Clinical outcomes were assessed using NYHA classification, ECG, and echocardiography.

Main Results:

  • Tumor necrosis factor-alpha (TNF-alpha) and C5b-9 were widely detected in the myocardium of DCM patients.
  • Despite significant improvements in NYHA classification and echocardiographic parameters across all groups, neither TNF-alpha nor C5b-9 expression correlated with clinical outcomes.
  • No significant correlation was found between TNF-alpha/C5b-9 and viral genome presence or inflammation markers.

Conclusions:

  • Myocardial expression of TNF-alpha and C5b-9 is prevalent in DCM but does not serve as a prognostic indicator.
  • Myocardial TNF-alpha is unlikely to be a useful prognostic marker for dilated cardiomyopathy.
Abstract

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